Cannulated Screw Fixation Of Fresh Scaphoid Fractures Observed

Objective:Through comparative study hollow tension screw and plaster cast asked for fresh scaphoid bone fracture,to evaluate the clinical efficacy of the hollow tension screw surgical methods.Through observation and comparison the effect of hollow tension screw and gypsum group, the clinical application level of hollow tension screw treatment for scaphoid fracture will be further improved in the end.Methods:All cases of October 2005 to March 2008 from orthopedic wards of Chinese medicine hospital in Hubei Province and Guangzhou Military Region, Army General Hospital and Beijing 304 Hospital. According to the standard case into the case and exclusion criteria, with open,fair,principle of random, 60 cases of fresh scaphoid fracture patients were divided into 30 cases of Group A (treatment group) hollow tension screw treatment and 30 cases of group B (control group) plaster cast treatment. the gender,age,the advantages of hand,Krimmer type and duration of patients in two groups have no significant deviation (P> 0.05) in statistical test, are comparable. Therapy group treatment programme: All cases were opened reduction and internal fixed with screw, and care fixed line forearm plaster buckling wrist in 15 degrees, slightly ulnar deviation postoperative.Gypsum fixed 6-8 weeks, X-ray show the growth of callus, fracture lines blurred, begin to exercise after the remove of the plaster. The control group conservative treatment:All cases were of the type casting, casting 12-14 weeks, do functional training after the remove of the plaster. From the pain, wrist activity (flexion and extension, partial-foot radius, pronation/ supination), wrist strength, with the use of hand and lead healthy side of excellent, good, satisfactory, poor four grades. through Krimmer wrist function score to evaluate the Hand objective function. All the cases were be counterchecked in one week,one month,three months,six months after treatment, a month after a follow-up, including patient follow-up visit, telephone, a questionnaire survey, to complet the collection of the scheduled observed data.Then SPSS13.0 for statistical analysis, the two groups before and after treatment with t-test score Krimmer, Krimmer grade rating by Ridit test. Testing whether there are indicators of significant deviation, thus comparing the advantages and disadvantages of the two methods,and the make further analysis and conclusions.Results:The indicators of treatment group and control group after treatment have improved significantly, the obvious deviation between before and after treatment are significant (P <0.05); Clinical curative effect has significantly deviation (P <0.05); the A2-efficient of fracture of the two cases were not significant (P> 0.05); B2,B4-efficient of fracture of the two cases were significantly deviation (P <0.05); Removing plaster time of the two cases were difference (P <0.05); The time of returning to work were significantly deviation (P <0.05).Conclusion:The results show that: A group (treatment group) hollow tension screw surgical treatment has many advantages,such as operation is simple, fixed-good effect, fixed a short time, nonunion and the incidence of low wrist after a good functional recovery, the patient recovered quickly. Clinical curative effect is better than group B (control group) conservative treatment, have greater advantages, it will have broad application prospects.